Glomerular score as a prognosticator in IgA nephropathy: its usefulness and limitation

Glomerular sclerosis, mesangial hypercellularity, extracapillary lesions, interstitial fibrosis, and vascular sclerosis have been reported to be the significant pathologic prognosticators in IgA nephropathy (IgAN). We developed our own scoring for the following main glomerular changes in 248 patients with IgAN: 1) glomerular hypercellularity (mesangial and endocapillary), 2) segmental lesions such as tuft adhesion, crescent and segmental sclerosis, 3) global glomerular sclerosis. Indices of each lesion were semiquantitatively determined. The sum of these three indices was defined to be a glomerular score. We found that a glomerular score significantly related to the outcome of patients with IgAN in univariate life table analysis. We also semiquantitatively determined total score including tubulo-interstitial and vascular lesions as well as glomerular score and compared the predictive power as a prognosticator between glomerular score and total score. Using Cox's proportional Hazard model and log-likelihood ratio test, we confirmed that predictive power of glomerular score was better than that of total score. Furthermore, we assessed the reproducibility of glomerular score using Kappa statistics. Three pathologists read 100 biopsies which were randomly selected from the materials and all pathologists read them twice. A value of Kappa between the first and second observation of pathologist A, B and C was 0.68, 0.71 and 0.60, respectively. Values of Kappa between Pathologist A and B were ranging from 0.45 to 0.47, those between Pathologist A and C from 0.30 to 0.36, and finally those between Pathologist B and C were ranging from 0.12 to 0.23. Therefore, intra-observer reproducibility was nearly excellent. And inter-observer reproducibility between Pathologist A and B was satisfactory. However, inter-observer reproducibility between Pathologist A and C and between B and C was not satisfactory. We feel our scoring system is very convenient and easy to be understood as a prognosticator in patients with IgAN. It, however, should be used by one pathologist because of excellent intra-observer reproducibility and rather unsatisfactory inter-observer reproducibility.

Lobular form idiopathic glomerulonephritis with massive subendothelial and paramesangial immune deposits, a three-year follow-up case

We report a patient with unusual glomerulonephritis. A 24-year-old Japanese female was hospitalized in October 1995 because of nephrotic syndrome. Lobular form glomerulonephritis with mesangial proliferation associated with massive wide-spread accumulation of slightly eosinophilic, periodic acid Schiff-positive amorphous materials in the luminal side of the capillary walls and paramesangial area was observed in the renal biopsy specimen. Immunofluorescent study revealed massive strong staining for IgM and C4 along the capillary walls and in the mesangium. Deposits of IgA, IgG, C3 and fibrinogen were also observed. Electron microscopy showed normal thickness of the capillary basement membrane and a large amount of subendothelial and paramesangial electron dense, finely granular deposits without fibrils or tubular structures. There were no clinical or laboratory findings of systemic diseases, such as systemic lupus erythematosus and cryoglobulinemia. Therefore, we believed that this case involved an unusual idiopathic glomerular disease with massive subendothelial and paramesangial immune deposits. Glomerulonephritis in this patient appeared to be resistant to treatment with corticosteroids and that this glomerulopathy may be a progressive disease as shown during the 3-year observation. Furthermore, our patient had idiopathic hyperprolactinemia and subclinical hypothyroidism. However, the relationship between glomerulonephritis and endocrinopathy in our patient is unknown.

Immunohistochemical detection of proliferating cell nuclear antigen and p53 expression in carcinoma of the extrahepatic bile duct

We used an immunohistochemical method to determine the concentrations of p53 and proliferating cell nuclear antigen (PCNA) to evaluate their usefulness as a predictor of malignancy and examined the relationship between PCNA and p53 in carcinomas of the extrahepatic bile duct (EHBD). Paraffin-embedded specimens from 46 patients were immunostained for PCNA and p53 using PC10 and DO7 monoclonal antibodies, respectively. The PCNA labeling index (LI) was closely associated with the stages of the tumor and depth of invasion (p < 0.05). The cumulative survival rate of patients with a low PCNA LI (LI < 47%) was found to be significantly better than that of patients with a high PCNA LI (LI > or = 47%) in all cases and patients with advanced cancer by univariate analysis (p < 0.05), but PCNA LI was not an independent prognostic factor in multivariate analysis. We detected p53 in 37% of the EHBD cancers. We also found that p53 positivity was not related to the percentage of PCNA-labelled cells or survival. The results suggest that PCNA immunoreactivity may be a useful predictor of malignancy in patients with EHBD carcinomas.

Amplification of the c-erbB-2 gene detected by FISH in gastric cancers

The amplification and overexpression of the c-erbB-2 gene are considered to be implicated in the process of carcinogenesis of a variety of human tumors. The amplification and overexpression of c-erbB-2 were investigated in 48 surgically resected human gastric cancers by means of fluorescence in situ hybridization and immunohistochemistry. DNA ploidy was determined by flow cytometry. The c-erbB-2 amplification was demonstrated as a cluster of signals, suggesting homogeneously staining region (HSR), in three tumors (6.3%) accompanied by the overexpression of its protein. Such overexpression was detected in another tumor without amplification of the c-erbB-2 gene. All tumors with amplification and overexpression of c-erbB-2 were differentiated adenocarcinoma histologically, but only 10.3 and 13.8% of differentiated carcinomas showed amplification and over-expression of the c-erbB-2 gene, respectively. There was no relationship between the amplification and overexpression of c-erbB-2 and the depth of tumor invasion and lymph node involvement. Three of four cases with overexpression of c-erbB-2 were classified into DNA aneuploid tumor.

Common deleted region on the long arm of chromosome 5 in esophageal carcinoma

BACKGROUND & AIMS

The existence of an unknown tumor-suppressor gene on 5q for esophageal carcinoma other than the APC gene has been suggested. The location of the putative tumor-suppressor gene on 5q, distinct from the APC gene, was examined.

METHODS

Sixty-one primary esophageal carcinomas were examined for nine microsatellite loci by the polymerase chain reaction followed by polyacrylamide gel electorophoresis. Loss of heterozygosity at the APC gene locus also was examined by the polymerase chain reaction-restriction fragment length polymorphisms.

RESULTS

Thirty-five of 61 esophageal carcinomas (57%) showed loss of heterozygosity at single or multiple loci on 5q, and the smallest common deleted region was identified at 5q31.1, the location of the IRF-1 gene locus. All tumors showing loss of heterozygosity at the APC gene locus showed complete or large interstitial deletions on 5q.

CONCLUSIONS

Deletion at the APC gene locus may just be the result of large deletions on 5q and may not be important in esophageal carcinogenesis, and the IRF-1 gene or other gene(s) on 5q31.1 may be the true target of frequent deletions on 5q that may play an important role in the pathogenesis of the majority of esophageal carcinomas.

[A case of so-called carcinosarcoma of the esophagus]

So-called carcinosarcoma of the esophagus is rare malignant tumors composed of carcinoma and sarcomataous components. We described a case of so-called carcinosarcoma and reviewed some literature. A 67-year-old man visited our hospital because of difficulty in swallowing, general fatigue, and sore throat. Barium swallow esophagogram showed a large polypoid lesion in the middle, lower thoracic esophagus. Endoscopy also demonstrated a pedunculated polypoid tumor. Histological examination of the biopsy specimen revealed malignant findings. Thoracic esophagectomy with cervical, thoracic, abdominal dissection was performed. A polypoid tumor, 10.5 x 5.2 x 3.5 cm in size, was removed. In the polypoid lesion, spindle-shaped cells made interlacing bundles similar to sarcoma and surrounded nests of squamous cell carcinoma. Near the pedicle, squamous cell carcinoma invaded muscularis mocosae. And lymph node metastasis was detected. Epitherial membrane antigen (EMA) was detected in some parts of the polypoid lesion. So according to Guide Lines for Clinical and Pathological Studies on Carcinoma of the Esophagus, this case was diagnosed as so called carcinosarcoma.

Monosomy of chromosome 18 detected by fluorescence in situ hybridization in colorectal tumors

BACKGROUND

At least two different evolutional pathways of colorectal cancer, namely the adenoma-carcinoma sequence and de novo carcinogenesis, have been indicated. However, whether there is a difference between them in affected chromosomes and genes has not yet been elucidated. Chromosomal examination is expected to provide a clue to an answer to this question. In this study, the relation of aberrations in chromosome 18 to type of colorectal cancer was examined.

METHODS

Numeric aberrations in chromosome 18 were investigated in 71 colorectal tumors by means of fluorescence in situ hybridization, using an alphoid satellite DNA probe specific for the pericentromeric region on chromosome 18.

RESULTS

The loss of one chromosome 18 was found in 33% (6 of 18) of patients with early cancer, excluding those with cancer in an adenoma. The loss was frequent in early colorectal carcinomas without foci of adenoma (four of six patients, 67%), whereas monosomy 18 was not significant in those with foci of adenoma except for patients with a hereditary background. Specimens exhibiting monosomy 18 were macroscopically classified as flat lesions, but the converse was not true. No adenoma showed monosomy 18. It was encountered in 44% of nine cancers with invasion to the muscularis propria. However, no significant subpopulation of monosomy 18 was present in cancers penetrating through the serosa or adventitia in which polysomic populations were often identified alternatively. Furthermore, tetrasomy for this chromosome was exclusive in these advanced cancers.

CONCLUSIONS

The loss of chromosome 18 is closely related to colorectal cancers without foci of adenoma.

Effects of cycloheximide on chromatin-bound and -unbound PCNA in HeLa cells

We examined the effects of cycloheximide on the amount of chromatin-bound and -unbound PCNA subpopulations in HeLa cells. The chromatin-bound PCNA content decreased rapidly in the presence of cycloheximide, whereas the reduction of the total amount of PCNA was minimal even 24 h after the treatment with cycloheximide. From these data, the half-life of PCNA was estimated to be 31.0 h for chromatin-bound PCNA and 276.8 h for the total.

Oxidized low density lipoprotein stimulates collagen production in cultured arterial smooth muscle cells

We examined the interactive effect of oxidized low density lipoprotein (LDL) and ascorbic acid on collagen production in cultured smooth muscle cells (SMCs). Porcine aortic SMCs were incubated with 50-200 micrograms/ml of human LDL with/without 5 microM Cu2+ for 24 h. Collagen production was assayed by successive salt precipitation at acidic and neutral pH after pepsin digestion of 3H-proline-labeled collagenous protein. Oxidation of LDL was evaluated by electrophoresis and by the level of thiobarbituric acid reactive substances (TBARS). Ascorbic acid reduced the oxidation of LDL + Cu2+ (53% reduction). In the presence of ascorbic acid, no differences were noted in collagen production between LDL and LDL + Cu2+. Without ascorbic acid, collagen production with LDL + Cu2+ was increased dose-dependently up to 6-fold with 150 micrograms/ml LDL, while no such effects were observed at any doses of native LDL. The addition of butylated hydroxytoluene to LDL + Cu2+ strongly suppressed oxidation (88% reduction), and significantly reduced collagen production close to that seen with native LDL. These results indicate that oxidized LDL stimulates collagen production in SMCs, while native LDL does not. Therefore, oxidized LDL may play a direct role in stimulating collagen production in SMCs, which could lead to collagenosis in atherosclerosis.

Intratumoral regional heterogeneity of DNA ploidy patterns in colorectal carcinomas

There is no agreement on the evaluation of intratumoral DNA ploidy heterogeneity, and its clinical significance remains controversial. We categorized intratumoral ploidy heterogeneity in an effort to avoid confusion and misunderstanding among investigators. We classified the heterogeneity into 3 major types (Types A, B and C) and a combined type (Type D), based on the intratumoral distribution profiles of DNA aneuploid lines identified by flow cytometry in 52 cases of colorectal cancer with intratumoral DNA ploidy heterogeneity selected from a consecutive series. Every carcinoma examined in this study fell into one of the 4 categories: Twenty-six tumors (50%) were classified as Type A, 6 (11%) as Type B, 2 (3%) as Type C, and 18 (36%) as Type D. We discussed the mechanisms of DNA ploidy heterogeneity evolution within a tumor, and also proposed a pathway to these types of DNA ploidy heterogeneity as an aid to understanding the relationship between tumor progression and DNA ploidy changes.

Flow cytometric analysis of p53 expression during the cell cycle

Mutant p53 expressed in many types of carcinoma lacks an inhibitory function on cell growth, but its role has been unclear. We performed two-parameter flow cytometry (FCM) to elucidate the relationship between the expression of p53 and the cell cycle in A431 cells. Fluorescence in situ hybridization proved that an A431 cell had two p53 genes whereas chromosome 17 was tetraploid. FCM showed that A431 cells expressed constantly high levels of p53 during the cell cycle. Under conditions of both serum deprivation and presence of hydroxyurea, p53 expression was decreased throughout the cell cycle, and the bivariate DNA/p53 distribution pattern during the cell cycle did not change. The expression of p53 was reduced to 60% for the first 4 h after the addition of cycloheximide, and showed no significant changes at least for 20 h. Treatment with Triton X-100 increased p53 immunoreactivity throughout the cell cycle. These results indicate that mutant p53 differs from proliferative markers such as PCNA, Ki-67 and DNA polymerase-alpha, and that there are no links between the expression of p53 and the cell cycle in A431 cells.

Identification of S-phase cells with PC10 antibody to proliferating cell nuclear antigen (PCNA) by flow cytometric analysis

We estimated the expression of proliferating cell nuclear antigen (PCNA) in HeLa S3 cells by flow cytometry with monoclonal antibody (MAb) PC10. HeLa cells were fixed with six different fixation procedures: 15-min and 30-min acetone, 15-min acetone followed by 15-min methanol (acetone/methanol), 30-min methanol, 15-min methanol followed by 15-min acetone (methanol/acetone), and a mixture of acetone and methanol. The fixed cells were applied to MAb PC10 against PCNA and then treated with FITC. With five fixation procedures except for acetone/methanol, PCNA was expressed in almost all cells with similar shapes and different FITC intensity levels on PCNA/DNA bivariate cytograms, whereas acetone/methanol fixation allowed PCNA detection in S-phase cells with a cytogram that showed a horseshoe-like pattern with a peak level at mid-S-phase. Flow cytometric dual parameter analysis of PCNA/BrdU was carried out in HeLa cells to confirm detection of PCNA in S-phase cells with acetone/methanol fixation. The population of cells stained for both parameters, i.e., S-phase cells, was obviously discriminated from that of the non-S-phase cell in PCNA/BrdU bivariate cytograms. These results strongly suggest that PCNA used with acetone/methanol fixation would be equal to BrdU as an S-phase marker.

Holographic motion picture by Eu(3+):Y(2)SiO(5)

Real-time recording of a moving object was made with persistent spectral hole burning of a cryogenic Eu(3+):Y(2)SiO(5) crystal. In a basic holographic configuration the ultrastable laser frequency was continuously scanned within the (7)F(0)-(5)D(0) absorption line (typically 200 MHz in 20 s) while the object was in motion, thus permitting the storage and reconstruction of the moving image. The success of this motion picture is attributable to (1) the kilohertz-wide hole width, (2) the quasi-persistent hole lifetime, and (3) the high hole-burning quantum efficiency of this material.

Kilohertz-resolution pump-probe spectroscopy in Pr(3+):YAlO(3)

We observed saturated absorption spectra of hole widths as narrow as 10.5 kHz with an excellent signal-to-noise ratio in a cryogenic Pr(3+):YA1O(3) sample, using a frequency-stabilized dye laser in a noncollinear frequency-domain pump-probe measurement. More-detailed theoretical and experimental analyses revealed the existence of an ultranarrow peak of width 10 Hz at the center of the line shape that could be attributed to grating diffraction of the pump beam.

Ultralong optical dephasing time in Eu(3+):Y(2)SiO(5)

We report what is to our knowledge the first measurement of linear and nonlinear spectroscopic properties for the (7)F(0)-(5)D(0) transition of Eu(3+):Y(2)SiO(5). Two clearly resolved lines at 579.879 and 580.049 nm, stemming from different sites, show dissimilar photoluminescence and hole spectra. In addition, these two sites have different inhomogeneous and homogeneous linewidths, which suggests that the local-field effect is smaller for one site. Specifically, the less affected site exhibits the longest dephasing time (822 micros) of any solid, which corresponds to a homogeneous linewidth of 387 Hz, and this linewidth is found to persist for hours without apparent spectral diffusion.

Time- and frequency-domain hybrid optical memory: 1.6-kbit data storage in Eu(3+):Y(2)SiO(5)

We propose and demonstrate a novel type of frequency-selective optical memory that writes and reads the data in both the time domain and the frequency domain. Temporal 16-bit data were stored by accumulated-photon-echo bit-by-bit storage at 103 frequency addresses within the inhomogeneous line of the (7)F(0)-(5)D(0) transition of Eu(3+):Y(2)SiO(5), which yields a total memory capacity of 1.6 kbits in a single spot of 240-microm diameter. The keys to the success of this experiment are this material's long dephasing time and lack of spectral diffusion.

Spectrally programmed stimulated photon echo

A stimulated photon echo has been observed from the artificially modulated inhomogeneous distribution of a medium. A cryogenic Eu (3+):YAlO(3) sample with a quasi-persistent hole lifetime is exposed to a frequency-scanned and intensity-modulated cw laser for multiple hole burning. A coherent burst equivalent to the stimulated photon echo is obtained by triggering this sample by a pulsed laser. We demonstrate further that any desired transient pulse shape can, in principle, be obtained by appropriate frequency-domain programming, which opens the way to a novel type of optical memory.

[A case of hepatocellular carcinoma associated with chronic renal failure on haemodialysis]

A 36 years old man with chronic renal failure on haemodialysis therapy presented with a hepatic mass which was diagnosed by ultrasonography, and was admitted to our hospital. Computer tomography and hepatic angiography revealed hepatocellular carcinoma of the right anterior superior segment of the liver. His liver function test, alpha-fetoprotein (AFP) and carcinoembryonic antigen levels in the serum were within the normal range. HBs antigen was also negative. Resection of right antero-superior segment was done following transcatheter arterial embolization. The tumor was homogeneous and light yellowish in color, and well demarcated by the capsule. Nontumorous tissue did not show either fibrosis or any inflammatory reaction. In general, hepatocellular carcinoma is associated with a positive HBs antigen and altered liver function. We here report a rare case of hepatocellular carcinoma in a man who was undergoing haemodialysis treatment for chronic renal failure with normal liver function test and negative HBs antigen.

248-Bit optical data storage in Eu(3+):YAlO(3) by accumulated photon echoes

The successful storage and retrieval of 248-bit temporal optical data in Eu(3+):YAlO(3) by accumulated photon echoes is reported. Owing to the long storage time of this crystal, the input data can be written bit by bit by quickly varying the separation of two laser pulses, while the stored data are recalled simultaneously after some storage period, which extends up to a few hours. The maximum data length, previously thought to be limited by the optical dephasing time T(2), has been found to be four times shorter than T(2) and attributable to spectral diffusion.

Waveguide-dispersion characteristics of dual-shape-core dispersion-shifted fibers

Waveguide-dispersion characteristics are discussed experimentally and numerically. The waveguide dispersions of both dual-shape-core (DSC) and graded-index types of dispersion-shifted fibers are evaluated from the measured wavelength dependence of the mode field radius. It is shown that the dispersion sensitivity to core-radius change of a bend-optimized DSC fiber is smaller than that of the graded-index dispersion-shifted fiber.

Characteristics of dual-shape core fiber with an alpha-index center core

The bending-loss and dispersion-sensitivity characteristics of a dispersion-shifted dual-shape core fiber with an alpha index center core are described. Calculations show that these characteristics can be improved by decreasing a and that a bend-optimized, dual-shaped core fiber exhibits a small bending loss and a large mode field diameter.

Selective stimulated Raman scattering in highly P(2)O(5)-doped silica single-mode fibers

Selective generation of the stimulated Raman Stokes wave in highly P(2)O(5)-doped silica single-miode fibers has been experimentally observed for the first time to our knowledge. It is assumed from the experimental results that the Stokes wave from P = O vibration interacts with the third Stokes wave from Si-O-Si vibration and is selectively amplified by Raman gain from the Si-O-Si vibration.